急性早幼粒细胞白血病患儿组织砷残留和生活质量的横断面研究

Arsenic retention in tissues and quality of life in pediatric acute promyelocytic leukemia treated with arsenicals:a cross sectional study

目的调查接受砷剂(ATO和RIF)治疗的急性早幼粒细胞白血病(APL)患儿组织中砷浓度和健康相关生活质量。方法于2022年7月11日—2022年9月7日开展一项横断面研究,期间36名APL患儿和17名健康儿童(对照组)纳入该研究。收集研究对象血浆、尿液、头发和指甲样本,测定各组织砷浓度。采用中文版PedsQL4.0普适性核心量表测定APL患儿健康相关生活质量。结果仅在停用砷剂(ATO和RIF)治疗不足3个月时,APL患儿各组织砷浓度高于健康儿童,有统计学差异。26例APL患儿完成了中文版PedsQL4.0普适性核心量表,在生理功能、情感功能、社会功能、学校表现四个类目及总分维度,不同砷浓度组别间无统计学差异,各类目总体得分基本接近正常人群。结论在使用砷剂(ATO和RIF)后,3个月内APL患者组织中的砷浓度会高于正常水平,之后会恢复正常。在不同砷残留水平的APL患儿之间未观察到健康相关生活质量的差异,提示APL患儿组织中的砷残留不是健康相关生活质量的直接影响因素。

Objective To investigate arsenic concentration in tissues and health-related quality of life in pediatric acute promyelocytic leukemia(APL)treated with arsenicals.Methods A cross-sectional study was conducted from July 11,2022,to September 7,2022,during which 36 children with acute promyelocytic leukemia(APL)and 17 healthy children(control group)were enrolled.Plasma,urine,hair,and nail samples were collected from study subjects,and arsenic concentrations in various tissues were determined.The Chinese version of the PedsQL 4.0 Generic Core Scales was employed to assess the health-related quality of life in children with acute lymphoblastic leukemia(APL).Results Arsenic retention in plasma,urine,hair and nail from patients who had been off the arsenic-containing treatment for less than 3 months were higher than the controls,respectively.Twenty-six APL children completed the Chinese version of PedsQL4.0and in the dimensions of physiological functioning,emotional functioning,social functioning,school performance,and overall scores,there were no statistically significant differences between different arsenic concentration groups.The scores in each dimension were generally close to those of the normal population.Conclusions After the application of arsenicals(ATO and RIF),arsenic concentrations in the tissues of APL patients are elevated within 3 months and return to normal after 3 months.Moreover,no differences in health-related quality of life were observed among children with acute promyelocytic leukemia at different arsenic concentrations,suggesting that arsenic concentration in the tissues of children with acute promyelocytic leukemia is not a direct influencing factor on health-related quality of life.